Acta Oto-Laryngologica最新文献

Background: Studies have shown that carotid artery reconstruction results in the best overall survival (OS) in Advanced Head and Neck Squamous Cell Carcinoma involving the Carotid Artery (AHNSCC-CA).

Aims: The purpose of this study was to evaluate the efficacy of covered stent implantation combined with radical tumor resection and to compare and analyze the historical literature on conventional carotid artery resection and reconstruction.

Materials and methods: A total of 68 patients with AHNSCC-CA were included in this study. This study compared the survival, local recurrence, surgical complications, and neurologic complications between the two groups.

Results: The OS rate at 12 months in the experimental group was 58.5% (median survival time: 15 months, 95% CI: 7.61-22.40). The OS rate at 12 months in the control group was 34.3% (median survival time: 8 months, 95% CI: 3.94-12.06, p = .371). In addition, the differences in the rates of local recurrence, surgical complications and neurological complications between the two groups were statistically insignificant (p = .677, p = .197 and p = .617).

Conclusions and significance: Compared with conventional carotid artery resection and reconstruction, covered stent implantation combined with radical tumor resection yields similar survival outcomes, but with significantly lower surgical risk and difficulty, and faster postoperative recovery.

Background: Immune checkpoint inhibitors (ICIs) occasionally cause immune-related adverse events (irAEs) in various organs. However, predictors of irAEs remain unidentified.

Objectives: We evaluated the predictors of irAEs and compared the outcomes of ICIs with and without irAEs in patients with recurrent/metastatic head and neck cancers (R/M HNCs).

Materials and methods: We retrospectively analyzed 157 patients with R/M HNCs who were administered an anti-PD-1 antibody between September 2014 and December 2022. We examined whether various pretreatment factors were associated with irAEs. The overall survival (OS) and progression-free survival (PFS) in patients with and without irAEs were analyzed.

Results: Overall, 44 patients (28.0%) developed irAEs. The survival curve estimated for patients with and without irAEs showed a significant difference in PFS (p = 0.018), but not in OS (p = 0.208). Multivariate analysis revealed significant differences in relative eosinophil counts (p < 0.001), TP (p = 0.014), and NLR (p = 0.002), which may be independent predictors of irAEs.

Conclusion: IrAEs may be associated with higher efficacy of ICIs and longer PFS. The relative eosinophil count may be predictors of irAEs and useful in routine medical practice. Using these biomarkers to predict irAEs will help predict ICI effects and manage irAEs.

Background: Delayed Meniere's disease (DMD) is characterized by episodic vertigo occurring after a significant delay following longstanding sensorineural hearing loss. However, its pathogenesis and characteristics remain unclear.

Objectives: To explore the characteristics of endolymphatic hydrops (EH) in DMD and investigate its pathology using MRI.

Materials and methods: 17 patients diagnosed with DMD were included in this study. A 3D-real-IR MRI sequence was utilized to visualize and grade EH. The signal intensity of the basal cochlear turn was compared to that of the cerebellar white matter to calculate the CC ratio. A paired t-test was employed to assess the differences in the CC ratio between the affected and unaffected sides in patients with unilateral DMD.

Results: EH was present in 100% of cases on the affected side. Unilateral EH was seen in 82.4%, and bilateral EH in 23.5%. Vestibular EH without cochlear involvement occurred in 29.4%, and cochlear EH without vestibular involvement in 5.9%. The CC ratio was significantly higher on the affected side (p < 0.01).

Conclusions and significance: A significant grade of vestibular EH was observed in DMD, with bilateral EH being relatively common. The increased contrast on the affected side may reflect the underlying pathology in DMD patients.

Background: The clinical phenotypes of CRS, such as the presence or absence of polyps, cannot well reflect the pathophysiological mechanisms and characteristics of patients. Only by distinguishing the different internal types of CRS can we individualize patients more accurately.

Objective: To investigate the clinical characteristics of chronic rhinosinusitis with different cell types (CRSwNP), and to provide a reference for the diagnosis and treatment of CRSwNP.

Materials and methods: The cytological endotypes of CRSwNP were divided into five groups by cluster analysis.

Results: There was a significant difference in the proportion of CRSwNP with different endotypes. There were significant differences in peripheral blood eosinophils, cerebrovascular disease, and unilateral and bilateral nasal polyps among CRSWNP patients with different cytological types.

Conclusions: Mixed CRSwNP and eosinophilic CRSwNP are the most common, while neutrophilic CRSWNP is the least common. Eosinophilic CRSwNP is more common in bilateral nasal polyps, with a high recurrence rate and a high probability of olfactory dysfunction. Neutrophilic CRSwNP is more common in elderly patients with cardiovascular and cerebrovascular diseases. Compared with total serum IgE, the percentage of eosinophils in peripheral blood is more helpful for the diagnosis of eosinophilic CRSwNP.

Background: In 2013, Japan established a standardized classification system for categorizing endoscopic sinus surgery (ESS) into types I-V, yet no evaluation has been conducted thereof.

Objective: We assessed the ESS trends and status in Japan, focusing on outpatient and inpatient surgeries.

Material and methods: This descriptive retrospective cohort study used Japan's National Database of Health Insurance Claims and Specific Health Checkups between 2014 and 2021. The distribution of ESS types I-V and outpatient and inpatient surgeries was analysed, along with age groups and regional differences, focusing on ESS type III.

Results: Overall, 427,813 ESS procedures were performed, with types III and IV being most common. Outpatient ESS type III increased substantially compared to inpatient surgeries. Younger individuals favoured outpatient ESS type III over inpatient surgeries, with substantial regional variations across prefectures.

Conclusions and significance: The adoption of a standardized ESS classification in Japan has facilitated a detailed understanding of surgical trends. The shift toward outpatient surgeries, especially for type III ESS, aligns with global trends toward minimally invasive procedures and reflects changing patient preferences and healthcare delivery practices. Consequently, continuous monitoring and research are crucial for adapting surgical practices to the evolving healthcare needs and patient expectations.

Background: Usher's syndrome type II (USH2) is a rare genetic disorder encompassing hearing loss, vision impairment, and apparent intact vestibular function. Recent research suggests a potential involvement of the otolith vestibular receptors in USH2.

Aims/objectives: Evaluate otolith dynamic function in USH2.

Material and methods: Twenty-two USH2 (median age 53.9 ± 2.99) and age-matched controls underwent a complete battery vestibular testing including air conducted cervical and ocular vestibular evoked myogenic potentials (c-VEMPs and o-VEMPs). Vestibular function tests were correlated with Activities Balance Scale (ABC) and Dizziness Handicap Inventory (DHI) scores.

Results: Fourteen USH2 reported previous vertigo (vs none control). Among 88 ears, c-VEMPs were absent in 15 USH2 cases and 4 controls (p = 0.034), while o-VEMPs were absent in 22 USH2 cases and 12 controls (p = 0.129). There were significant differences between USH2 vs controls in right ear o-VEMP N1 latencies (median 11.60/10.40, p < 0.010), N1-P1 amplitudes (median 5.15/10.10, p < 0.003) and in o-VEMP N1-P1 asymmetry ratio (median 24.78/40.50, p < 0.014). USH2 showed a strong correlation between o-VEMP amplitude and DHI score (p = 0.003, ρ = 0.769). No association was found between vertigo and VEMPs subgroups.

Conclusions and significance: Our findings suggest the presence of otolith dysfunction in USH2, which is independent from subjectively reported dizziness. Incorporating vestibular testing into USH2 evaluation and monitoring could enhance characterization of this multisensory disease.

Background: It has been shown that there is a link between thyroid-related diseases and hearing loss.

Objectives: The purpose of this study is to investigate the relationship between thyroid-related diseases and hearing loss by conducting a meta-analysis.

Material and methods: A thorough search was carried out in the following electronic databases: PubMed, Cochrane Library, Embase, Web of Science, Google Scholar, Semantic Scholar, and ResearchRabbit. The chi-square test and the I² index examined the research's heterogeneity. A funnel plot and the Eger test were used to examine publication-biased effects.

Results: A total of 48,507 individuals (6482 hypothyroid patients, 4162 hearing loss patients, and 37863 controls) were included in this meta-analysis of 18 research. Individuals with hypothyroidism had a 1.69-fold increased risk of hearing loss compared to those without the condition (OR: 1.69; 95% CI: 1.11-2.57, p < 0.001). among hypothyroidism, the prevalence of hearing loss was 24% (EC: 0.24; 95% CI: 0.11-0.39, p = 0.00), while among hearing-impaired individuals, the prevalence of hypothyroidism was 7% (EC: 0.21; 95% CI: 0.07-0.40).

Conclusion: This study demonstrated how thyroid dysfunction can raise the chance of hearing loss. To completely comprehend the underlying mechanisms and create efficient treatments for this illness, more study is required.

Background: The mechanism of human papillomavirus (HPV)-induced tonsillar squamous cell carcinoma (TSCC) has not been clearly elucidated, and the number of authenticated HPV (+) TSCC cell lines is extremely limited.

Objectives: To establish and characterize a de novo HPV (+) TSCC cell line derived from a Korean patient with TSCC.

Materials and methods: We performed in vitro and in vivo experiments for evaluation of tumorigenicity of our TSCC cell line. In addition, we evaluated the stemness traits of this cell. Finally, we examined the physical status of our cell whether this belonged to the episomal, integrated, or mixed type.

Results: The novel tonsillar cancer cell line, designated as KUSCC-152, was identified as a de novo TSCC cell line positive for HPV-16. In addition, the KUSCC-152 cell line has cancer cell traits in vitro and can induce tumor formation and metastasis to the neck lymph nodes in heterotopic and orthotopic xenograft mice. Moreover, the KUSCC-152 cells exhibited a cancer stemness phenotype, including sphere-forming capacity and the expression of stemness markers. Finally, we suggested that KUSCC 152 may belong to an integrated HPV incorporation type.

Conclusions and significance: We successfully established and characterized a novel integrated-type HPV (+) TSCC cell line from an East Asian patient.

Background: An objective measurement of speech perception would be valuable in hearing-impaired patients who are unable to perform auditory tasks reliably.

Objectives: To investigate the feasibility of cortical auditory evoked potentials (CAEPs) evoked by different spectro-temporal modulation (STM) signals and provide reference for the further exploration of acoustic change complex (ACC) in hearing-impaired patients.

Method: 29 normal hearing (NH) adults were recruited and stimulated randomly by STM signals at 6 spectral modulation rates: 0, 1, 2, 4, 8, 16 cycles/octave, at each of 4 temporal modulation rates: 0, 2, 4, 8 Hz, to elicit ACC response.

Results: The change of spectral modulation rates ≤ 16 cycles/octave at 0 Hz temporal modulation rate had different impacts on latency. 0, 1 cycles/octave, and 4, 8 Hz made a difference to the P2-N1 amplitude easily. 8, 16 cycles/octave were more unstable in rejection rate. No significant difference existed in waveform repetition rate among different STM rates. No significant interaction effect existed in spectral and temporal modulation.

Conclusions: STM as a stimulus signal to induce ACC response had its feasibility. 2 cycles/octave at spectral modulation rate and 2 Hz at temporal modulation rate had better stability and waveform repeatability in NH adults.